| NPI | 1639691975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND PT16814) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL14620) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2024-07-17 |